Lisa N Young, MPT, ATC – Physical Therapist

Key facts

NPI: 1386669828
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapist 225100000X
License: 2994 (NH)
Practice address: 122 NH Route 12a
Langdon, NH 03602-8221
Phone: (603) 835-7828
Fax: (603) 835-7827
NPI assigned: Jul 13, 2006
Sex: Female
Sole proprietor: Yes

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Fall Mountain Physical Therapy and Athletic Training, PLLC Physical Therapist · Langdon, NH · NPI 1417047689

NPD (past) Authorized official PHYSICAL THERAPIST
Lynn Boudreau PT II LLC Physical Therapist · Keene, NH · NPI 1508943069

NPD (past) PHYSICAL THERAPIST
Weeks and Gowen Physical Therapy Associates Inc Physical Therapy Clinic/Center · Charlestown, NH · NPI 1215954946

NPD (past) PHYSICAL THERAPIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
0036	NH	MD	Athletic Trainer

Practice roles

Organization	Specialty	Status	New patients
Lynn Boudreau PT II LLC	Physical Therapist	Past since Jan 1, 1999	Accepting new patients
Fall Mountain Physical Therapy and Athletic Training, PLLC	Physical Therapist	Past since Jul 10, 2006	Accepting new patients
Weeks and Gowen Physical Therapy Associates Inc	Physical Therapist	Past since Oct 22, 2024	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist	225100000X	2994	NH	Yes
Athletic Trainer	2255A2300X	0036	NH

Addresses

Primary practice location

122 NH Route 12a
Langdon, NH 03602-8221

Mailing address

PO Box 57
Alstead, NH 03602-0057
Phone (603) 835-7828

Other identifiers

Identifier	Type	State	Issuer
AA65774	Other	NH	HARVARD PILGRIM
30394477	Medicaid	NH
P00339333	Other	NH	RAILROAD MEDICARE
08Y007675NH03	Other	NH	ANTHEM BCBS
6007380	Other	NH	MVP

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 29, 2007.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1386669828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57",
            "city": "ALSTEAD",
            "state": "NH",
            "postal_code": "036020057",
            "telephone_number": "603-835-7828",
            "fax_number": "603-835-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 NH ROUTE 12A",
            "city": "LANGDON",
            "state": "NH",
            "postal_code": "036028221",
            "telephone_number": "603-835-7828",
            "fax_number": "603-835-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "LISA",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "MPT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "2994",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NH",
            "license": "0036",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA65774",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30394477",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00339333",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "08Y007675NH03",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "6007380",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Langdon, NH

Zandra J Reagan, MS, NCSP
Paul Soltysiak
Brian Stoning, M.S.P.T.
Sara Jane Valli, M.A., CCC-SLP
Erin Van Genderen, RD, LDN

All providers in Langdon, NH · Physical Therapist in New Hampshire

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.